The first morning back at work after a baby can feel strange. She packs a pump instead of a lunch. She checks her phone for photos from the sitter or the daycare. She sits in a meeting and realizes she has not thought about anything but the baby for months.

Many women are glad to return. They miss their colleagues, their work and the feeling of adult conversation. Others go back because they have to, and the separation stings. Most feel some mix of both.

For some, though, the return to work arrives at the same time as depression that has been building since the birth, or it sets off depression on its own. And at work, where she is expected to be capable and composed, it can be easy to hide.

A heavy load in a new shape

Going back to work does not end the demands of a young baby. It adds to them. She may still be waking at night, then commuting, working a full day, pumping on breaks and coming home to dinner, baths and bedtime.

Many mothers feel pulled in two directions. At work, they worry they are missing their baby's life. At home, they worry they are falling behind at work. That constant sense of not doing enough anywhere can wear her down.

Depression after birth can begin anytime in the first year, which means it can show up right around the time many women return to their jobs.

Signs to notice, at home and at work

Partners and family members may see some signs at home. Coworkers and managers may notice others. Watch for:

• A mood that stays low, anxious or flat for more than a couple of weeks
• Crying often, or seeming close to tears much of the time
• Trouble focusing, making decisions or keeping up with tasks that used to be easy
• Pulling away from coworkers, friends or family
• Talking about feeling like a failure as a mother, an employee or both
• Saying she feels hopeless, trapped or like a burden to the people around her

Starting a plain conversation

At home, a partner or relative can pick a quiet moment and say what they have seen. You might tell her that the return to work seems to be weighing on her, and that you are worried about how she is feeling. Ask how she is really doing, then listen without rushing to solutions.

A trusted coworker or friend can do something similar. Asking a colleague if she wants to grab coffee, and then asking how she is holding up since coming back, can open a door. Keep it private and kind.

If anything she says sounds hopeless, ask her directly whether she is having thoughts of suicide. People often worry that this question will put the idea in someone's mind. It does not. Asking directly lets her know she can be honest, and for many people it comes as a relief.

If she says yes, stay with her. Do not leave her alone with it. Help her reach care right away, and if you are a coworker, help her connect with someone close to her as well.

Making care easier to reach

Many women still have postpartum follow-up visits in the months after birth, and the baby continues to see the pediatrician regularly. Both kinds of visits include questions about the mother's mood. Encourage her to answer honestly, even if she worries it will look like she is not coping.

The National Maternal Mental Health Hotline is available any hour of the day or night. She can call or text 1-833-852-6262 for free, during a lunch break, on the drive home or in the middle of the night.

Many workplaces offer an employee assistance program, which can connect workers with confidential counseling. A partner or friend can help her look into what her job provides.

At home, share the load in concrete ways. Handle daycare drop-off some mornings. Take over evening chores so she can rest. Protect her weekends from extra obligations.

Managers can help by being flexible where possible and by making it clear that asking for support will not count against her. A workplace that treats mothers with patience gives them room to speak up when they are struggling.

The return to work is a big change. Noticing how she is handling it, and asking plainly, can help her through it.

If you or someone you know is thinking about suicide, call or text 988, the Suicide and Crisis Lifeline, any time. In an emergency, call 911.